Explained: When and how to use oxygen support if you test positive for Covid-19

The photo is for representational purpose only

With the coronavirus crisis worsening over the past few weeks, India's health infrastructure has been under tremendous pressure. Most states are struggling to meet the demand for beds, medicines and oxygen support. Between oxygen cylinders, oxygen concentrators, and breathing in the prone position, there are artificial and natural methods for maintaining oxygen levels. Mid-day.com spoke to Dr Vikrant Shah, consulting physician, intensivist and infectious diseases specialist, Zen Multispeciality Hospital Chembur, to understand what to use and when.

Dr Vikrant Shah

When does a Covid-19 patient require oxygen support?

Oxygen saturation means the amount of blood in one's body. When it comes to adults, the oxygen saturation in blood should be above 95 to 100 percent. If it goes below 90 then it can be termed hypoxemia. If the oxygen saturation level falls below 80 then the organs like one's heart and brain might stop functioning properly, causing failure of the organs or even cardiac arrest. Shortness of breath, headache, restlessness, confusion, high blood pressure, and visual disorders are some of the symptoms you must watch out for if you have low oxygen levels. If you are Covid-positive and your oxygenation is below 90 then you will require oxygen and close monitoring in the hospital.

What are the various equipments available and required for oxygen support? Can you please explain how they work?

Oxygen therapy, nasal cannulae, mask, non-invasive ventilation like CPAP (continuous positive airways pressure) or BiPAP (bilevel positive airways pressure) are some of the ways one can make sure that they get fully controlled oxygen delivery of 100 percent. This will ensure that you get the recommended amount of oxygen and you breathe freely.

Is there a difference in how oxygen support is to be used at-home versus in-hospital?

An oxygen concentrator can be used at home when the patient's saturation level falls and they need oxygen support. It will fulfill the need for oxygen and your health will not deteriorate further. One can rely on this device before the ambulance arrives. At the hospital, the devices like NIV or oxygen therapy used can be controlled by the expert. For using at home, you will have to consult your doctor who will explain to you how to use the device.

Some suggest prone position for breathing issues. Can you explain whether this helps?

India's ministry of health issued guidelines recommending proning to Covid-19 patients who are undergoing treatment at home. Proning is a position of lying down that improves one breathing comfort and oxygen flow in the body. The proning position is beneficial to individuals who have compromised breathing. Lying down in the supine position can worsen your pulmonary function. But sleeping in a prone position can do the trick. For proning, you'll require 5 pillows. One to two pillows can be placed below the neck, one underneath the chest via upper thighs, and two pillows under your shins. Start with sleeping face down from 30 minutes till around two hours, then shift to lying left sideways for half an hour to approximately two hours. Then, sit up for 30 minutes to 2 hours. Shift to lying sideways, that is on the right side, around 2 hours. Then sleep on your stomach. Do not prone immediately after having your food, and avoid proning if you feel uncomfortable.

Are there other natural ways to increase oxygen levels? If yes, are they advisable?

Getting fresh air can help you improve your oxygenation. Just keep the window open in the morning. Stay hydrated to maintain a good oxygen level and drink water from time to time. There are certain foods that are beneficial to enhance the oxygen levels in the body. Thus, you will have to opt for iron-rich food like kale, broccoli, legumes, apples, and eggs. Exercise on a daily basis to maintain a good oxygen level in the body. Do some breathing exercises after consulting your doctor.

Any misinformation related to oxygen support that we should watch out for?

There is a viral post on social media about the therapeutic effects of camphor in maintaining good oxygen levels. Camphor does not improve oxygen levels but it can give one a soothing and comforting effect in patients suffering from respiratory illnesses. There is no concrete evidence available regarding the benefits of camphor when it comes to improving oxygenation or no study is conducted to back this claim. The logic behind smelling the camphor is ensuring that your sense of smell is intact and it opens up your nasal pathway. Do not follow any forwards on social media without your doctor's advice as trying home remedies can be dangerous sometimes.

What is your advice to asymptomatic patients to keep their oxygen levels stable?

Check your SPO2 levels at home at least twice a day, morning and evening. Exercise at home, drink enough water, and do breathing exercises. Except asymptomatic Covid patient at home check oxygen saturation with 6 mins walk every 3 hours

How are hospitals dealing with the oxygen shortage?

Covid-positive patients are struggling to breathe as there is a shortage of oxygen. Infrastructure and cost constraints tend to explain the shortage of oxygen around the world. The production and delivery of oxygen is a complex process. Oxygen is delivered to the hospitals in cylinders and it is very costly. There is a limited amount of oxygen in the cylinder and can be used by one patient. Many people have lost their precious lives gasping for breath. States like Maharashtra, Gujarat, Madhya Pradesh and Haryana are battling for breath. Even hospitals are struggling to admit patients who are unable to breathe owing to a lack of oxygen supply. Here, an oxygen concentrator is a good alternative, and Covid-positive people who need oxygen can use this at home as well. This will reduce the burden on hospitals.

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On Monday, the daily number of Covid-19 cases in Maharashtra dropped to 48,700, taking the count of infections to 43,43,727 while 524 deaths pushed the toll to 65,284, the state health department said.

(With inputs from Nascimento Pinto and PTI)